My Holy Friday the 13th

The day began just like all other days on that August Friday in 2004. I was on the pulmonary consult service in the hospital, and on the agenda was a bronchoscopy on a patient in the coronary care unit. "Cool," I thought, because I absolutely love performing bronchoscopies. Bronchoscopy, for those not in the medical field, is a procedure in which a flexible tube with a light and camera on the end is placed through the nose and into the lung. I can actually see the airways on a video monitor, and we can do various procedures, such as biopsies. I had to perform a biopsy of the patient's lung tissues that morning.

I paid absolutely no attention that it was Friday 13th.

The "bronch," as we pulmonologists like to call it, started out as smooth as all others I have done in the past. I talked to the patient beforehand; I gave the patient numbing medication in his nose and throat; I gave him sedating medicine so he could be more comfortable. Getting into the lung was not problematic, either. Everything was fine.

I did the biopsy, and as expected, there was some bleeding. Usually, this stops right away. In this patient, however, it did not. The blood kept coming, and coming, and coming, and coming. I tried to stop the bleeding, but I could not. I was prepared to stand there for as long as I needed to until the bleeding stopped, but the nurse told me the last thing I wanted to hear: "Doc, sats are 74."

That means that the oxygen level is dangerously low. Another colleague was with me during the procedure, and he suggested I pull the scope out and place him on a high amount of oxygen. I agreed and did just that; the problem was the oxygen level still stayed low. Thus, I had to intubate the patient, which means place a breathing tube down his windpipe to help him breathe and stabilize the airway.

There was blood everywhere. I tried to suction out as much as I could, but the blood kept coming. Thank God, it slowed down to the point where I could see his vocal cords, and I placed the tube into his windpipe.

We confirmed the location of the tube and were breathing for him, but I could not relax. I had since called for help, and almost immediately, a barrage of people showed up. Suddenly, the patient lost his pulse and blood pressure. CPR was immediately instituted, and we administered emergency medicines in his IV. I suctioned out as much blood as I could from his airway. Thank God, his pulse and blood pressure returned. We rushed him back to the coronary care unit. His blood pressure was dangerously low, despite multiple medications that increase blood pressure. Things did not look good.

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